![]() This article reviews common causes of lymphadenopathy, and presents a methodical clinical approach to a patient with cervical lymphadenopathy. Generalized lymphadenopathy should prompt further clinical investigation. Patients with unexplained localized cervical lymphadenopathy presenting with a benign clinical picture should be observed for a 2- to 4-week period. Malignancy should be considered when palpable lymph nodes are identified in the supraclavicular region, or when nodes are rock hard, rubbery, or fixed in consistency. Lymph nodes larger than 1 cm in diameter are generally considered abnormal. Although most cervical lymphadenopathy is the result of a benign infectious etiology, clinicians should search for a precipitating cause and examine other nodal locations to exclude generalized lymphadenopathy. With such a high frequency of occurrence, oral health care providers need to be able to determine when lymphadenopathy should be investigated further. There are no written guidelines specifying when further evaluation of lymphadenopathy is necessary. It is likely that over half of all patients examined each day may have enlarged lymph nodes in the head and neck region.
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